Perinatal hepatitis B is the chronic hepatitis B virus infection transmitted from mother to child, predominantly via vertical transmission during pregnancy or the perinatal period [1]. It is a major contributor to the global reservoir of chronic HBV infection [1].
Disease overview
Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Perinatal hepatitis B refers to chronic HBV infection acquired through mother-to-child transmission, which constitutes the majority of chronic HBV cases worldwide [1]. It remains a global health burden with ongoing endemic persistence and significant morbidity and mortality [1]. Pregnancy represents a key intervention window for eliminating this transmission route through offspring immunization and maternal management [1].
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Infants affected by perinatal transmission may test positive for hepatitis B surface antigen at birth or at six months of age, indicating established infection [2]. The condition manifests as chronic HBV infection rather than acute illness in the newborn period [1][2].
Chronic HBV infection from perinatal transmission is endemic globally and accounts for the majority of chronic HBV cases, representing a leading source of long-term morbidity and mortality [1]. The World Health Organization has set a 2030 eradication target, with vertical transmission recognized as the principal driver of persistent infection burden [1].
The primary mode of perinatal hepatitis B is vertical transmission from mother to child, responsible for most chronic HBV infections [1]. High maternal viremia increases the risk of immunoprophylaxis failure and persistent infection in the newborn [1].
Routine antenatal screening of pregnant women and neonatal immunoprophylaxis are the central measures to reduce perinatal HBV transmission [1]. Timely newborn vaccination is essential, and highly viremic mothers may receive antenatal antiviral treatment to prevent immunoprophylaxis failure [1]. Tenofovir alafenamide fumarate during pregnancy was as effective as other antivirals in lowering mother-to-child transmission rates without adverse infant outcomes [2].
- 1 Cheung KW et al. Prevention of perinatal hepatitis B virus transmission. Arch Gynecol Obstet. 2019 Aug. PMID: 31098821. doi: 10.1007/s00404-019-05190-0. PubMed: https://pubmed.ncbi.nlm.nih.gov/31098821/
- 2 Huang J et al. Effectiveness and Safety of Tenofovir Alafenamide Fumarate in the Prevention of Perinatal Hepatitis B Transmission: A Meta-Analysis. Dig Dis Sci. 2024 Mar. PMID: 38341392. doi: 10.1007/s10620-023-08258-9. PubMed: https://pubmed.ncbi.nlm.nih.gov/38341392/
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